Keisha Formanek, COTA/L
NPI #1073322103 in West Union, Iowa
Provider Information
- NPI Number
- 1073322103
- Entity Type
- Individual
- Name
- Keisha Formanek, COTA/L
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Occupational Therapy Assistant
- Credential
- COTA/L
- Enumeration Date
- Jan 3, 2025
- Last Updated
- Jan 3, 2025
Practice Location
- Address
- 112 JEFFERSON ST
- City
- West Union
- State
- Iowa
- ZIP Code
- 52175-1022
- Phone
- (563) 422-3811
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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